Popular weight loss drugs may play a factor in vision loss, review shows

SALT LAKE CITY — Utah researchers say diabetes and weight loss drugs may have an impact on vision loss and other eye complications because they work too well.

Semaglutide and tirzepatide are active ingredients in popular weight loss drugs like Ozempic, Wegovy, Zepbound and Mounjaro. A recent review by the Moran Eye Center found these ingredients may play a role in vision complications, such as eye stroke.

“We don’t know for certain if these drugs caused the eye problems that we identified,” said Bradley J. Katz, MD, PhD and Moran Eye Center Neuro-Ophthalmologist. “But, the eye problems that we identified were atypical or unusual enough that there is some concern that these drugs might have contributed to the eye problems these patients experienced.”

The investigatory review looked at nine patients from across the country who experienced vision issues while taking popular drugs for weight loss and diabetes.

Three patients developed, “potentially blinding eye conditions impacting the optic nerve.” Seven experienced nonarteritic anterior ischemic optic neuropathy, known as eye stroke. One had papillitis and another developed paracentral acute middle maculopathy.

The vision loss was irreversible in eight of these nine patients.

The weight loss drugs may be working “too well”

This review, along with other research, led Moran scientists to hypothesize that the drugs are doing what they are supposed to. But, they’re doing it so well that it could be causing problems.

“These drugs are so effective at dropping your blood sugar, that in some patients their blood sugar may have dropped too rapidly,” said Katz. “It’s that rapid decline in their blood sugar that might have caused the eye complications, and not necessarily a direct toxic effect of the drug itself.”

Several studies are in the works looking into this hypothesis and more are planned.

“There is a lot of interest in this topic because there are so many patients taking these drugs,” he said. “There’s lots of other people that are interested in trying to figure out what’s going on and what to do about it.”

Nearly 2% of the nation’s population received a prescription for semaglutide in 2023.

Despite the potential harmful side effects of these drugs, scientists are not recommending patients stop using them.

“We’re not recommending that anybody stop these drugs, because they’re very effective in what they do. Our advice to patients and physicians is that, if you’re going to use these drugs, just taper onto them slowly,” said Katz.

However, patients are recommended to reach out to a primary care physician and ophthalmologist if they experience vision loss or a change in vision while taking one of these medications.

Because of the potential widespread effects of these drugs, Katz and other ophthalmologists, including the American Academy of Ophthalmology, are asking the Food and Drug Administration to help them receive more information.

“[We are] encouraging the FDA to force the companies that manufactures these drugs to do some post-marketing surveys to find out how prevalent these eye problems really are,” he said.

Relate: Dieting by design: Using Ozempic as a diabetic weight loss treatment